Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
Dgtz Gls Mcrscp Sld Lvl V
New York, NY
See all hospitals reporting CPT 0754T →Price type
Hospital for Special Surgery’s median price of $117 is 72% above the median hospital's median price ($68), higher than 60% of the 543 hospitals reporting CPT 0754T. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 5 payers, 60 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | ||||
|---|---|---|---|---|
| 1 | Blue Cross Blue Shield bcbs epo [102204] percent of total billed charges · bothfrom % of charges | $79.00 | $79.00 | $79.00 – $79.00 |
| 2 | Blue Cross Blue Shield bcbs federal [102202] percent of total billed charges · bothfrom % of charges | $79.00 | $79.00 | $79.00 – $79.00 |
| 3 | Blue Cross Blue Shield bcbs hmo [102207] percent of total billed charges · bothfrom % of charges | $79.00 | $79.00 | $79.00 – $79.00 |
| 4 | Blue Cross Blue Shield bcbs nyc healthline [102208] percent of total billed charges · bothfrom % of charges | $79.00 | $79.00 | $79.00 – $79.00 |
| 5 | Blue Cross Blue Shield bcbs nyship empire plan [102209] percent of total billed charges · bothfrom % of charges | $79.00 | $79.00 | $79.00 – $79.00 |
| 6 | Blue Cross Blue Shield bcbs pos [102206] percent of total billed charges · bothfrom % of charges | $79.00 | $79.00 | $79.00 – $79.00 |
| 7 | Blue Cross Blue Shield bcbs ppo [102205] percent of total billed charges · bothfrom % of charges | $79.00 | $79.00 | $79.00 – $79.00 |
| 8 | Blue Cross Blue Shield bcbs connection [102217] per diem · both | $98.67 | $98.67 | $98.67 – $98.67 |
| 9 | Cigna allied benefit system - cigna network [133700] percent of total billed charges · bothfrom % of charges | $106.18 | $106.18 | $106.18 – $106.18 |
| 10 | Cigna cigna [103500] percent of total billed charges · bothfrom % of charges | $106.18 | $106.18 | $106.18 – $106.18 |
| 11 | Cigna cigna epo [103502] percent of total billed charges · bothfrom % of charges | $106.18 | $106.18 | $106.18 – $106.18 |
| 12 | Cigna cigna great west [103506] percent of total billed charges · bothfrom % of charges | $106.18 | $106.18 | $106.18 – $106.18 |
| 13 | Cigna cigna hmo [103503] percent of total billed charges · bothfrom % of charges | $106.18 | $106.18 | $106.18 – $106.18 |
| 14 | Cigna cigna indemnity [103505] percent of total billed charges · bothfrom % of charges | $106.18 | $106.18 | $106.18 – $106.18 |
| 15 | Cigna cigna international [103507] percent of total billed charges · bothfrom % of charges | $106.18 | $106.18 | $106.18 – $106.18 |
| 16 | Cigna cigna ppo [103504] percent of total billed charges · bothfrom % of charges | $106.18 | $106.18 | $106.18 – $106.18 |
| 17 | Cigna daniel h cook - cigna [133900] percent of total billed charges · bothfrom % of charges | $106.18 | $106.18 | $106.18 – $106.18 |
| 18 | Cigna local 831 [103508] percent of total billed charges · bothfrom % of charges | $106.18 | $106.18 | $106.18 – $106.18 |
| 19 | Cigna luminare - cigna [136200] percent of total billed charges · bothfrom % of charges | $106.18 | $106.18 | $106.18 – $106.18 |
| 20 | Cigna trustmark - cigna [134300] percent of total billed charges · bothfrom % of charges | $106.18 | $106.18 | $106.18 – $106.18 |
| 21 | Blue Cross Blue Shield emblem bcbs composite [901202] percent of total billed charges · bothfrom % of charges | $107.44 | $107.44 | $107.44 – $107.44 |
| 22 | Blue Cross Blue Shield bcbs nj [102301] percent of total billed charges · bothfrom % of charges | $109.02 | $109.02 | $109.02 – $109.02 |
| 23 | Blue Cross Blue Shield bcbs nj ppo [102302] percent of total billed charges · bothfrom % of charges | $109.02 | $109.02 | $109.02 – $109.02 |
| 24 | Aetna aetna [100300] percent of total billed charges · bothfrom % of charges | $116.92 | $116.92 | $116.92 – $116.92 |
| 25 | Aetna aetna epo [100305] percent of total billed charges · bothfrom % of charges | $116.92 | $116.92 | $116.92 – $116.92 |
Last updated: Apr 1, 2026
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